Reliability of measurements of the extension-flexion ratio with surface EMG.

BACKGROUND: The surface electromyography (sEMG), by evaluating the paraspinal muscle activity, may be used for diagnosis and evaluation of rehabilitation effectiveness patients with low back pain. OBJECTIVE: The purpose of the study was to determine the intra- and inter-session reliability of the measurement of the activity of the lumbar erector spinae (LES) activity (extension-flexion ratio). METHODS: The study included 21 asymptomatic subjects, aged 14 to 27 years, mean 23.7 ± 2.9. The LES muscle activity was assessed with using of the sEMG during forward trunk flexion and extension by two examiners. Based on the quotient of the LES muscle activity obtained during four concentric and eccentric tasks the extension-flexion ratio was calculated. RESULTS: The measurements displayed excellent or fair-to-good reliability (intraclass correlation coefficient ranged from 0.90 to 0.68). The typical error and coefficient of variations, ranged from 0.34 to 0.58, and from 13.7 to 21.9, respectively. CONCLUSIONS: The measurement of the extension-flexion ratio performed with the use of sEMG shows high level of intra- and inter-session reliability, suggesting that this parameter is a reliable tool in evaluation of the lumbar paraspinal muscles activity. However, the level of typical error should be taken into account.

The comparison of the effects of three physiotherapy techniques on hamstring flexibility in children: a prospective, randomized, single-blind study.

The aim of the study was to evaluate changes in hamstring flexibility in 120 asymptomatic children who participated in a 6-week program consisting of one physiotherapy session per week and daily home exercises. The recruitment criteria included age (10-13 years), no pain, injury or musculoskeletal disorder throughout the previous year, physical activity limited to school sport. Subjects were randomly assigned to one of the three groups: (1) post-isometric relaxation - PIR (n = 40), (2) static stretch combined with stabilizing exercises - SS (n = 40) and (3) stabilizing exercises - SE (n = 40). Hamstring flexibility was assessed with straight leg raise (SLR), popliteal angle (PA) and finger-to-floor (FTF) tests. The examinations were conducted by blinded observers twice, prior to the program and a week after the last session with the physiotherapist. Twenty-six children who did not participate in all six exercise sessions with physiotherapists were excluded from the analysis. The results obtained by 94 children were analyzed (PIR, n = 32; SS, n = 31; SE, n = 31). In the PIR and SS groups, a significant (P<0.01) increase in SLR, PA, FTF results was observed. In the SE group, a significant (P<0.001) increase was observed in the SLR but not in the PA and FTF (P>0.05). SLR result in the PIR and SS groups was significantly (P<0.001) higher than in the SE group. As far as PA results are concerned, a significant difference was observed only between the SS and SE groups (P = 0.014). There were no significant (P = 0.15) differences regarding FTF results between the three groups. Post-isometric muscle relaxation and static stretch with stabilizing exercises led to a similar increase in hamstring flexibility and trunk forward bend in healthy 10-13-year-old children. The exercises limited to straightening gluteus maximus improved the SLR result, but did not change the PA and FTF results.

The influence of self-stretching based on postisometrical relaxation, static stretching combined with stabilizing exercises, and stabilizing exercises only on the flexibility of one-joint and two-joint hip flexors.

BACKGROUND AND OBJECTIVE. The limitations of muscle flexibility are a common dysfunction of the musculoskeletal system. Therefore, various therapeutic techniques are used in rehabilitation programs to increase their flexibility. The aim of this prospective, randomized, single-blind study was to evaluate the changes in the flexibility of hip flexors in children who participated in a 6-week therapeutic program consisting of one physiotherapy session per week with a physiotherapist and daily home exercises. MATERIAL AND METHODS. A total of 94 children aged 10-13 years were randomly assigned to 3 experimental groups: postisometrical relaxation group (PIR group), static stretching combined with stabilizing exercise group (SE/SS group), and stabilizing exercise group (SS group). To assess the flexibility of one- and two-joint hip flexors, the modified Thomas test was used. The examination was conducted by blinded observers. RESULTS. A significant improvement in the flexibility of one-joint hip flexors was documented in all 3 groups (P<0.01). The flexibility of two-joint hip flexors increased significantly only in the SS/SE group (P<0.05). After the program, the highest range of motion of the hip extension (test for one-joint hip flexors) was recorded in the SS/SE group (20.6° ± 4.5°), and it was significantly greater than in the SE group (16.6° ± 4.0°, P<0.05). There were no significant differences in the knee flexion (test for two-joint hip flexors) among all 3 groups (P>0.05). CONCLUSIONS. The 6-week therapeutic program regardless of the technique applied (postisometrical muscle relaxation, static stretching with stabilizing exercises, and stabilizing exercises only) resulted in the increased flexibility of one-joint hip flexors. Only static stretching combined with stabilizing exercises led to a significant increase in the flexibility of two-joint hip flexors.

Evaluation of the stress level of children with idiopathic scoliosis in relation to the method of treatment and parameters of the deformity.

Stress level due to existing body deformity as well as to the treatment with a corrective brace is one of factors influencing the quality of life of children with idiopathic scoliosis undergoing non-surgical management. The purpose of the study was to evaluate the stress level among children suffering from idiopathic scoliosis in relation to the method of treatment and the parameters of the deformity. Seventy-three patients with idiopathic scoliosis participated in the study. Fifty-two children were treated by means of physiotherapy, while 21 patients were treated with both Cheneau corrective brace and physiotherapy. To assess the stress level related to the deformity itself and to the method of treatment with corrective brace, the two Bad Sobernheim Stress Questionnaires (BSSQs) were applied, the BSSQ Deformity and the BSSQ Brace, respectively.